The two choices for in home care are home care agencies and private caregivers. The decision will have implications in terms of training, cost and other pros and cons referred to in private caregiver vs. home care agency. Think carefully about your caregiving situation and what your priorities are. Do you want to get the biggest bang for your buck? Is time and convienience most important? Does managing payroll and tax records seem complicated? Do you want more control in the caregiver selection process? Furthermore, don't rule out the possibility of hiring a private caregiver in combination with a home care agency to care for your loved one.
When taking the path of hiring a private caregiver, first determine what type of aide your elderly parent needs based on their level of independence, preferences, and financial means. Most often, frail elderly persons need a home care worker with prior caregiving experience including performing personal care such as bathing and dressing, safe transferring, assistance with walking, meal preparation and/or assistance with eating. If your elderly parent has dementia or doesn't require hands on care, then you may be able to manage with a sitter or companion that simply ensures their comfort and safety. If you're looking for some basic household assistance with cleaning, laundry and so forth, then a housekeeper or choreworker will suffice. Don't become confused by all the various terms used to describe caregivers, instead focus on finding someone with the appropriate qualifications and experience that can properly care for your elderly parent. A certified aide is not necessary when hiring privately and can be a potential advantage for expanding the applicant pool. Once you determine what kind of assistance is needed, prepare a list of duties for the caregiver. This job description will later serve as a contract to be signed by the newly hired assistant and yourself. The most difficult step, but by no means impossible, is actually finding the appropriate caregiver for the job.
By far one of the easiest and best ways to find a private caregiver is to have a personal recommendation from a trusted friend or relative. Word of mouth is often the most successful means, so be sure to ask neighbors, acquaintances from your church, clubs, and organizations where you are a member. If you belong to a support group, ask other family caregivers and if you don't belong, consider joining one even if it's just for this reason. Perhaps you personally know a nurse, social worker, or therapist in your community that can give you some leads or ideas. If your loved one has been hospitalized or in a nursing home/rehab facility, be sure to ask the professional health care workers you meet such as discharge planners or staff nurses, and especially other nurse aides. In the event your loved one has received Home Health services through a Medicare certified agency following an illness, make sure you inquire among those nurses and aides about possible referrals. Recalling from my experiences as a visiting nurse, it is quite common for home health professionals to be keenly aware of available caregivers and they are often familiar with community resources for locating help.
If you advertise in the papers or online, screen the applicants carefully over the telephone and save time by interviewing only the qualified ones personally. Before scheduling an interview, ask for identification, training or certifications, and check references carefully.
Consulting with local employment agencies, your Area on Aging, or local social services are other good resources for directing you to caregiver solutions. Older persons with limited incomes or qualifying for Medicaid, may be eligible for free or low cost assistance from nurse aides or choreworkers that is subsidized by their county or state. They may also refer you to volunteer services for help with transportation, home repairs, or meals on wheels.
In certain situations, I have suggested that my clients consider hiring an independent caregiver for part of the time and hire a home care agency for the remaining time. Remember that it's never reasonable to expect an employee to work on a 7 day-a-week basis. The advantage of a joint caregiver arrangement whether arranged with two private workers or a combination of an agency and private worker, is the likelihood of more reliable staffing, reduced overall costs, and having a viable back-up plan in place.
Clare Absher is a Registered Nurse with 43 years of experience. Most of her experience is in home health serving as a caregiver, educator, patient advocate, and liaison between families and community resources. She has also worked in acute care, assisted living, and retirement settings. She is passionate about helping families care for their elderly loved ones at home.
